Case Study: Sexual Abuse – James’ Story

James was referred to the NSPCC by his social worker when he was seven. He had been sexually abused by his father and several other men, sometimes as a group.

The abuse started when James was about five. His father had also sexually abused James’ sister when she was about ten. In addition, both children experienced emotional abuse and witnessed physical and verbal domestic abuse within the home.

The abuse came to light when James’ sister told a friend at school. James' mum took appropriate action despite physical risks to herself, and co-operated, although cautiously, with professionals.

Following James’ abuse, he began to display aggressive and violent play and was observed touching the bottoms of other children in school. James’ mum described having great difficulty getting close to him, as a result of her own abusive past, and her sense of repulsion about the activities he had been involved in. She stated that on reflection he had always been an angry and distant child.

The NSPCC practitioner assessed that James needed to be able to stop his sexual and other aggressive behaviour as well as having more positive relationships –especially with his mum. Alternative support was also identified for James’ sister. In play therapy, James was a very angry little boy.

Within months of the case opening he was transferred to a specialist school as his behaviour was too problematic to be managed in mainstream schooling. In a more specialist environment he benefited from one-to-one time, varied teaching methods, and greater structure.

His behaviour however remained problematic. James’ play was often very focussed, but upon violence, mutilation, destruction and above all, a sense of desolation. Within his play there would often be fierce battles that almost got resolved, but then a further disaster would occur. In particular James would often enact fights where the ‘baddie’ would convince everyone he had changed, but then deceive everyone, and commit further atrocities. James often drew very bleak, dark, ‘scribbly’ pictures, depicting death, killing, torture, and loss. He often cut up his artwork, and was rarely satisfied with his results. During the sessions he explored his emotions, and behaviours.

This work opened the door to explore relationships, the impact of his behaviours on himself and others, as well as alternative behaviours and strategies he could use. He bravely explored these issues, despite his fear of reprisal, and usually developed strategies for managing or modifying his behaviour. In turn he was able to determine whether behaviour is ok or not and recognise peoples’ right to choose.

His mum was also involved in much of this work and took on how she could improve their relationship and give positive, clear messages to him. Within sessions we explored the underlying causes of his behaviours, and he could fairly easily see the links between his mum’s difficulties in her relationship with him, and his own poor self-esteem. This led to further intensive work with him and mum to develop fun times together, and a range of activities and strategies for managing the tough times. His mum worked to establish bedtime routines, limits on spending, and improving the family garden to provide play space.

On one occasion James dismembered a fashion doll in a horrific attack that could only be described as rape. He began to identify a hero who could protect the doll, and over a series of weeks he worked through very challenging themes to do with roles and protection.

He shared his sense of inadequacy that he had not protected mum, but also his anger that no-one had protected him either. Slowly, James began to believe that neither he nor his mum were to blame. James began to direct his anger specifically towards his dad, and for a period of around six months his play was aggressive, repetitive, and without resolution. James also began to describe a deep love for his mum, and a belief that she loved him. This was very different from the little boy who had described feeling hated by everybody.

In subsequent sessions he was able to link the abuse he suffered with his misunderstandings about how to behave, or what was ok or not. He was able to describe confusion between fear, pleasure and anger and to acknowledge that he could be responsible for his own behaviour now, but not in the past.

He is now able to place his anger and to utilise methods for releasing strong negative feelings in harmless ways. He is developing a sense of empathy, and a willingness to receive positive praise.

Even though James may always have challenges in his life due to the horrific abuse by his father, he now recognises the love that he gets from his mum, the security of his environment, and a set of social rules that guide him towards adulthood.